scholarly journals Primary health care in China: is China’s health reform reform for the whole nation?

2017 ◽  
Vol 18 (04) ◽  
pp. 398-403 ◽  
Author(s):  
Jing-Min Cheng ◽  
Yong-Xu Yuan ◽  
Wei Lu ◽  
Le Yang

Background: Good primary health care can enhance national health status at relatively low cost. The barefoot doctor model in China was once considered to have been a successful health care policy. It was a model which was followed by other low-developed or developing countries. In recent decades, the Chinese government promulgated a number of new policies and health reforms to improve its health care system. Aim: This paper aimed to highlight the great significance of primary health care and appeal to the policymakers to change the priority to primary health care in order to be able to guarantee universal health care for the whole nation at least at primary care level. Method: This study discussed Chinese primary health care by reviewing its history and development. Finding: Chinese government’s efforts do not seem to be leading to a completely successful outcome for all the people of China as a result of the substantial imbalance of investments between tertiary level hospitals and grass-root level health care institutions. The government appears to have neglected the importance of primary health care in the implementation of health systems and resources.

Author(s):  
Le Yang ◽  
Hongman Wang

Abstract Background: The maternal mortality ratio (MMR) is not only an important indicator of maternal and infant safety, but also a sign of the development of economy, education, and medical care in a country. In the last 60 years, the Chinese government has implemented various strategies and policies to reduce the MMR, especially in the rural areas. Aim: This study aimed to discuss the strategies developed by the Chinese government, showing the successful experience of Chinese intervention programs and highlighting the challenges to the government in the context of current economic and social status. Method: This study probed into the Chinese government’s efforts and achievements in the MMR reducing by reviewing the relevant health policies, extracting the data from China Health Statistics Yearbook of 2015, analyzing the reduction of maternal death in rural areas and the major causes from 1991 to 2015, comparing the MMR trend in urban and rural areas, and discussing the changes of the situation in China. Finding: Although it seems that Chinese government’s efforts have brought evangel to the rural pregnant women and significantly reduced rural maternal mortality, the government still needs to develop more equitable and flexible primary health care policies to narrow the imbalance in health resource allocation and pay more attention to the health care for the rural-to-urban migration in China.


2021 ◽  
Author(s):  
Huanhuan Jia ◽  
Hairui Jiang ◽  
Jianxing Yu ◽  
Jingru Zhang ◽  
Zhou Zheng ◽  
...  

Abstract Background: The serious shortage of primary health care (PHC) providers is a common issue in the health reforms worldwide, including in China. The government of China have proposed that encouraging and guiding qualified medical personnel to work in primary medical and health care institutions (PMHCIs) is an effective way to improve the overall quality and efficiency of PHC, but it has not produced good results. The problem of insufficient human resources of PHC has not been substantially ameliorated.Methods: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PMHCIs from the perspective of guided objects. Through a three-phase investigation of 1,160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.Results: A total of 5 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PMHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG, whereas CCPL had no significant direct effect. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of the institution and the willing of medical personnel to seek employment at PMHCIs. The values of fit index indicated an acceptable-fitting model.Conclusion: Family, remuneration, individual development, and job responsibility are closely related with the willingness of medical personnel to seek employment at PMHCIs, and the internal and external environment of PMHCIs is also an important factor. Based on this, targeted measures can be proposed to promote the development of PHC providers.


2021 ◽  
Vol 15 (2) ◽  
pp. 168
Author(s):  
Meimi Laillah ◽  
Ridwan Manda Putra ◽  
Suyanto Suyanto

TTuberculosis (TB) is a chronic infectious disease caused by the Mycobacterium tuberculosis (MTB) which affects the lungs and other organ., Indonesia is the third highest after India and China and Indonesia’s top ten causes of death in Indonesia. The purposeofthis study wastodeterminestrategycontrolof the TB Program in Pekanbaru City. Thisstudyisresearchwith SWOT analysisandsurveyanddirectinterviews in thefield,and the studyisgoing onJanuary-February 2021 at Pekanbaru City Primary Health Care, Tenayan Raya and Simpang Tiga PrimaryHealth Care.interview and survey with a total sampling method of 84 samples. The study’s resultsfrom the government policy involved that supporting the TB program in   Pekanbaru cityisrespectable. At thesametime, fromthecommunity in thefield, there are stillpeoplewhodo not understand TB disease, forexample, theincidenceof TB disease, mode oftransmission, andthedurationoftreatmentandprevention. Suggested in controllingthe program TB disease, it is necessary to provide education and explanation to sufferers and the surrounding community


Author(s):  
Ranti Suciati ◽  
Mujiati Mujiati ◽  
Novianti Novianti

Abstrak Semakin meningkatnya jumlah kasus HIV/AIDS di Indonesia, berdampak tidak hanya pada masalah kesehatan, memacu pemerintah untuk melibatkan masyarakat sipil dalam Organisasi Berbasis Komunitas (OBK) untuk ikut berperan dalam upaya pencegahan dan penanggulangan HIV/AIDS. Pentingnya identifikasi kendala atau hambatan yang dihadapi oleh OBK memunculkan strategi atau alternatif solusi untuk mengatasi kendala, serta memberikan gambaran model intervensi yang lebih sinkron antara pemerintah dan masyarakat. Desain penelitian adalah kualitatif dengan melakukan studi kasus di dua LSM Peduli AIDS di Jakarta. Informan dipilih secara purposive sampling yaitu pengurus, anggota/petugas, dan dampingan dari dua OBK. Pengumpulan informasi dengan wawancara mendalam berdasarkan pedoman wawancara dan diolah menggunakan metode content analysis. Kendala yang dihadapi OBK yaitu alur rujukan BPJS yang mengikuti domisili sehingga memberatkan pasien, kurang optimalnya koordinasi dan kerjasama antara OBK dengan Puskesmas, belum meratanya kualitas dan kapasitas SDM anggota OBK, persoalan administratif organisasi, sumber dana yang tidak selalu kontinu, adanya perbedaan kepentingan antara OBK dengan pihak kepolisian, serta masih tingginya stigma masyarakat terhadap penderita HIV/AIDS. Solusi mengatasi kendala OBK dilakukan dengan peningkatan efektifitas pelaksanaan program pemerintah melalui OBK, antara lain dengan penerapan fleksibilitas pengelolaan dana berdasarkan kinerja OBK, peningkatan kapasitas SDM, pemantapan sistem manajerial, pemahaman alur layanan kesehatan di Puskesmas, serta social support bagi penderita HIV/AIDS. Kata kunci: organisasi berbasis komunitas, LSM, HIV/AIDS Abstract The increasing number of HIV/AIDS cases in Indonesia that impact not only on health issues, spur the Government to involve civil society in community-based organizations (OBK) to play a role in HIV/AIDS prevention program. Identification of constraints or obstacles faced by OBK do as they can generate alternative strategies or solutions to overcome these constraints, and provide a more synchronous model of intervention between the government and the community. This type of research is a case study at two AIDS Awareness NGOs in Jakarta. The informants were chosen by purposive sampling ie the board, members/officers, and assistants from the two NGOs. Information collection with by in-depth interview based on interview guideline and processed using content analysis method. Constraints faced by the OBK is the issue of referral flow pathways that follow the domicile so burdensome patients, less optimal coordination and cooperation between OBK with primary health care, uneven quality and capacity of human resources of NGO members, organizational administrative issues, sources of funds that are not always continuous, different interests between the OBK with the police department, and the stigma. Reduction of obstacles faced by OBK can be done by increasing the effectiveness of government program implementation through OBK, among others by applying flexibility of fund management based on OBK performance, human resource capacity building, managerial system strengthening, understanding of health service flow in primary health care, and social support for patient HIV/AIDS. Keywords: community-based organizations, NGOs, HIV/AIDS


Author(s):  
Lara Arcipreti Boel Souza ◽  
Heliny Carneiro Cunha Neves ◽  
Natália Del Angelo Aredes ◽  
Isabel Cristina Lima Jobim Medeiros ◽  
George Oliveira Silva ◽  
...  

ABSTRACT Objective: To report the experience of the nursing supervised curricular internship in the program “O Brasil Conta Comigo” carried out in the Covid-19 pandemic. Method: Experience report of activities developed in Primary Health Care in a municipality in the southern region of the state of Goiás during the Covid-19 pandemic, from April to November 2020. Results: The inclusion in the government program allowed the strengthening of the student’s active role in the teaching-learning process and teaching-service approximation, with the student as the point of connection, which resulted in the implementation of actions for the fight against the pandemic in the municipality, such as elaboration, implementation, and evaluation of the service flowchart for people with suspected Covid-19. Conclusion: The experience was successful, as it consolidated knowledge regarding leadership and autonomy, integration between theory and practice, critical thinking, and evidence-based problem solving. The participation in the program allowed for contributions to assistance and management in the actions to combat the new coronavirus in the scope of primary care, as well as for the contribution to the training of the student tutored by nurses in the field and supervised by professors from the federal university of origin.


2012 ◽  
Author(s):  
Mary P. Finlayson ◽  
Nicolette F. Sheridan ◽  
Jacqueline M. Cumming ◽  
Sandra Fowler

2019 ◽  
Vol 10 ◽  
pp. 215013271988150 ◽  
Author(s):  
Hojatolah Gharaee ◽  
Jafar Sadegh Tabrizi ◽  
Saber Azami-Aghdash ◽  
Mostafa Farahbakhsh ◽  
Majid Karamouz ◽  
...  

Background: This study aims to analyze the public-private partnership (PPP) policy in primary health care (PHC), focusing on the experience of the East Azerbaijan Province (EAP) of Iran. Methods: This research is a qualitative study. Data were gathered using interviews with stakeholders and document analysis and analyzed through content analysis. Results: Participants considered political and economic support as the most important underlying factors. Improving system efficiency was the main goal of this policy. Most stakeholders were supporters of the plan, and there was no major opponent. Implementing the health evolution plan (HEP) was an opportunity to design this policy. Participants considered the lack of provision of infrastructure as the main weakness, changing the role of the public sector as the main strength, and promoting social justice as the main achievement of policy. The results of the quantitative data review showed that following the implementation of this policy, health indicators have been improved. Conclusions: Based on the results of this study, the PPP model in EAP is a new and successful experience in PHC in Iran. Supporting and developing this policy may improve the quality and quantity of providing care.


2000 ◽  
Vol 6 (4) ◽  
pp. 43
Author(s):  
Vivian Lin

The primary health care sector faces a number of challenges. Some of these are in the form of persistent problems which include, inter alia, health disparities in resources and outcomes, a fragmented health system, issues of power with respect to priority setting and resource allocation, and a poor information and evidence base with which to allocate resources and evaluate outcomes. These problems are perennially accompanied by a gap between the rhetoric of policy and the reality of implementation. Neo-liberal reforms present a series of challenges to primary health, with the introduction of unit-cost funding, competitive tendering and increased user pays. Changing epidemiological patterns, the rise of evidence-based medicine, and new information and communication technology all question accepted methods of practice. Eroding community confidence in government and professionals, and the growing polarisation of society are also cause for concern. Three areas for development in primary health care policy and practice may provide the keys for dealing with these challenges. These are, first, the development of integrated service delivery models, which move away from narrowly defined single purpose programs delivered by one provider. Second, the development of innovative policy and managerial tools that support the objectives of primary health care while addressing the concerns of policy makers. Finally, the development of a strategic research and development agenda that effectively links policy, research and practice.


1996 ◽  
Vol 2 (3) ◽  
pp. 38 ◽  
Author(s):  
Brigid McCoppin ◽  
Christine Birrell

Amalgamation of community health centres has become a fairly common response to Victorian government changes in primary health care policy (both Labor and Coalition). This is a study of one such amalgamation and of its effects. The amalgamation brought staff and management many difficulties of adjustment, but it has produced a larger organisation which, while it has some residual problems, appears well fitted to withstand the pressure of today's policy directions and to meet future demands.


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